American Board of Surgical Assistants (ABSA) Orthopedic Practice Test

What is the likely diagnosis for a teenage girl with persistent wrist pain after minor treatment?

1. Sprained wrist

2. Fractured navicular bone

3. Tendinitis

4. Carpal tunnel syndrome

The correct answer is: Fractured navicular bone

The diagnosis of a fractured navicular bone, commonly known as the scaphoid bone, is particularly relevant for a teenage girl with persistent wrist pain following a minor trauma. The scaphoid is one of the small bones in the wrist that can easily be overlooked in initial assessments, especially if a sprain or soft tissue injury seems more likely at first. Even if a minor injury did not initially appear serious, a fracture in this area can lead to ongoing pain due to the bone's critical role in wrist stability and movement. Additionally, the scaphoid has a partial blood supply, which can complicate healing if not correctly diagnosed. A fracture in this bone can also lead to complications, such as nonunion or avascular necrosis, if the initial fracture is missed. The persistent nature of the wrist pain, rather than the transitory discomfort that might accompany a sprain or tendinitis, strongly suggests the need to investigate further for a fracture. Symptoms like pain during activities that involve wrist movement and tenderness in the anatomical snuff box are classic indicators of a scaphoid fracture. In comparison, the other potential diagnoses present different clinical scenarios. A sprained wrist often resolves over time with rest and conservative treatment, while tendinitis typically shows